It started with a toothache.
asserted
It → start → toothache
John Pike, 18 at the time, was prescribed Tylenol 3s, which contain codeine.
asserted
which → prescribe → codeine
The pills relieved the pain but something else changed inside him.
asserted
something → relieve → him
In his 20s, Pike was working as a highrise window cleaner, a job he held for two decades, before he sought another opioid prescription, Percocet, for back pain related to his job.
asserted
he → work → job
When his prescription was cut off, he started using methadone to avoid withdrawal symptoms and manage his pain.
asserted
he → cut → pain
But he eventually relapsed and starting using morphine, OxyContin, heroin and finally, fentanyl.
asserted
he → relapse → morphine
Pike, now 51, a client at the Parkdale Queen West Community Health Centre, said the decades of opioid use have ravaged his body, his relationships with his family and his housing stability.
asserted
decades → say → family
“Definitely as you get older, it takes more of a toll on your body,” Pike said.
asserted
Pike → get → body
“With fentanyl, it felt like it was eating me from the inside out.”
asserted
it → feel → inside
A new study from researchers at Unity Health reports that older adults in Ontario, specifically those over 55, have been hit hard by the fentanyl/opioid drug poisoning crisis and are one of the most vulnerable age groups in the throes of addiction.
asserted
adults → report → addiction
While Pike is just under the age group for the study, he recognizes he’ll be heading there fast.
asserted
he → recognize → study
The researchers characterize their findings as an “overlooked and evolving crisis among older adults” that the health-care system isn’t prepared for.
asserted
system → characterize → that
A tranquilizer in Toronto street drugs that defies traditional overdose responses is adding to the strain on hospitals.
asserted
that → defy → hospitals
A tranquilizer in Toronto street drugs that defies traditional overdose responses is adding to the strain on hospitals.
“They are going to be left behind more and more as time goes on if we don’t react quickly,” said Tara Gomes, an epidemiologist, professor at the University of Toronto and principal investigator of the Ontario Drug Policy Research Network at Unity Health Toronto, as well as co-author of the report.
asserted
Gomes → defy → report
Some of the notable findings are that people seeing care for opioid addiction doubled between the third quarter of 2017 and the fourth quarter of 2025, from 7,116 to 15,231 people, which researchers said is likely an underestimate.
asserted
researchers → see → people
Opioid overdose deaths among older adults have also increased significantly, rising from 1.1 per 100,000 people in 2013 to 1.8 per 100,000 by 2024, which is in line with trends among other demographics.
What’s driving the increases is multifactorial.
asserted
driving → increase → increases
The aging population is a major factor, but there was also rapid expansion of pharmaceutical opioids (especially OxyContin) in the mid- to late 1990s, following by a steep decline the 2010s, which may have left some people switching to street opioids.
uncertain
which → age → opioids
Finally, the toxic drug supply has played a significant part.
asserted
supply → play → part
Over the study years, fentanyl use increased among older adults.
asserted
use → increase → adults
By the last quarter of 2024, about 62 per cent of opioid overdose deaths in this cohort involved fentanyl, which doubled from 31 per cent in the second quarter of 2017.
asserted
which → involve → 2017
Pharmaceutical opioids were also a significant contributor to opioid toxicity deaths among older adults, accounting for 32 per cent of deaths over the study period, and was most pronounced among adults 75 and over.
asserted
opioids → account → adults
“There’s this history of how people got here, but then also the reality of what’s causing the harm right now, which is that potent unpredictable drug supply,” Gomes said.
asserted
Gomes → ’ → harm
While the overprescribing of pharmaceutical opioids for various health conditions in the ‘90s and early 2000s is mentioned in the report, it doesn’t conclusively say this is the cause for the increases.
asserted
this → mention → increases
But after fentanyl blew up around 2016, Gomes said doctors became extremely cautious about prescribing opioids, with strict guidelines and increased oversight of physicians.
asserted
doctors → blow → physicians
“The second part of this crisis has been the rapid de-prescribing,” said Dr. Chetan Mehta, an addictions specialist in Toronto who has worked at supervised consumption sites in the city.
asserted
who → say → city
“There is a tremendous fear about prescribing regular opiates,” he added, while also highlighting the risks of abruptly taking people off opioids without adequate supports.
asserted
he → be → supports
Gomes is calling for closer co-ordination between long-term-care homes and Ontario’s Ministry of Long-Term Care to boost service capacity and beds in institutions that can adequately support people who use drugs, and more comprehensive training for workers in care facilities.
asserted
who → call → facilities
She added that family members, loved ones, friends and personal support workers play an important role in paying attention to if an older adult is on a harmful trajectory with substance use.
asserted
adult → add → use
“This is a wake-up call to the fact that there is a large number of people who have developed opioid use disorders over decades, who are now surviving this toxic drug supply, aging and have complex care needs,” Gomes said.
asserted
Gomes → wake → needs
“And the health-care system doesn’t really understand that.”
asserted
system → understand → that
The Aporia
